“Why Should I Tell My Business?” an Emerging Theory of Coping and Disclosure in Teens: Focus Groups to Understand Perspectives of Pre-Depressive Moods

Objective: Disclosing pre-depression feelings of sadness is difficult for teens. Primary care providers are a potential avenue for teens to disclose these feelings and a bridge to mental health care before becoming more seriously ill. The aim of this study was to explore how to more effectively recruit teens into CURB (Chicago Urban Resiliency Building), a culturally adapted preventive mental health intervention for the primary care setting. 

Method: We held five focus groups with African-American and Latino teens, ages 13 to 18 years, (n=43) from a large Midwestern city. We conducted constant comparative analysis of the focus group data and incorporated researchers' field notes. A robust theoretical conceptualization of coping and disclosure emerged. 

Results: Our analysis revealed an internal coping continuum in reaction to sadness, and pivotal elements of trust and judgment that either lead teens to disclose or not disclose these feelings. Major barriers to communicating these feelings were lack of trust, fear of judgment and intense reaction when disclosing emotional difficulty.  The teens’ perspectives show the necessary characteristics of a relationship, and comfortable community and virtual settings that can best allow for teens to take the step of disclosing in order to receive mental health care services.  

Conclusion: The theoretical conceptualization of coping and disclosing is a new contribution to the empirical literature. It explicates the delicate internal process that teens experience, showing clinicians the foundational necessities of trust and relationship in order for teens to disclose and get clinical help to prevent worsening of their sadness. Our findings have implications for policy, demonstrating the importance of co-locating community centers and primary care settings in order to collaborate on mental health interventions.